Home Physician Assistant Services PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HOME PHYSICIAN ASSISTANT SERVICES PC

Practice address

2119 E 15TH St Ste B1
Brooklyn, NY 11229-4376

Phone

(718) 339-2901

NPI assigned

Aug 26, 2020

Last updated

Aug 26, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Khaled Elbanna

Title

MD

Phone

(646) 321-2331

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Enrollment records 2

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Editha Lopez Quirino

  • Family Nurse Practitioner
  • Queens, NY
  • NPI 1306695960
  Medicare reassignment NPD
• Mark H Vine, M.D.

  • Urology Physician
  • Cedarhurst, NY
  • NPI 1386668010
  Medicare reassignment NPD
• Nick Nicolaev Nicoloff, RPA-C

  • Medical Physician Assistant
  • Brooklyn, NY
  • NPI 1992769632

  NJ

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1639782972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 E 15TH ST STE B1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294376",
            "telephone_number": "718-339-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 E 15TH ST STE B1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294376",
            "telephone_number": "718-339-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME PHYSICIAN ASSISTANT SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "ELBANNA",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "646-321-2331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Home Health Physical Therapy PC
• Home Infusion Group Inc.
• Home Medical Suplly Center Inc (1800wheelchair.com)
• Home Meds LLC
• Home Physical Therapy Provider PC
• Home Respiratory & Medical Equipmen (Franklin & Carroll Drugs)
• Home Side Wellness PT OT Massage Therapy PLLC
• Home Solution RN P.C.
• Home Speech Home Inc
• Home Sweet Home ABA LLC

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.